This year San Antonio Breast Cancer Symposium (SABCS) celebrated its 40th anniversary. As in the past years, this year's conference was held in Henry B. Gonzalez Convention Centre, San Antonio, Texas, on 5-9 December 2017. The conference highlighted many different topic on breast cancer including basic science, translational research, local therapies, systemic therapies, survivorship, early clinical trials, and surgical topics. Even though SABCS evolved towards basic science and systemic therapy based manner in recent years, there were some important topics about local therapies and surgical approach. In this conference report, presentations and keynote talks about surgical field and local therapies will be summarised.